House — Episode 2 (Season 6): “Epic Fail”
This episode explores what happens when Foreman takes over the team after House quits. And the results are, frankly, dull. The House scenes were good, but the hospital scenes were uninspired. Even the usually humorous theme of “internet medicine is better than real medicine” couldn’t do much more than evoke a tired chuckle
Vince is a game programmer working on a virtual reality first person shooter. He has to drop out in the middle of a gaming session because he suddenly develops a severe burning pain in his hands. He is initially evaluated in the emergency room and told that his nerve conduction studies are normal (so no carpal tunnel) and his bloodwork is negative (which is quite a work-up for the ER). Instead of continuing to work this up as an outpatient, Vince is admitted to the hospital.
Currently, the team consists of Foreman, Taub, and Thirteen. Foreman has taken over the team because House has handed in his official resignation. Cuddy tells Foreman he has one chance to prove to her he can run the team. Looking at Vince’s case, the team suggests diabetic neuropathy (but his HbA1c, a blood sugar test, is normal), hypothyroidism (but no other symptoms match), or complex regional pain syndrome (a difficult to treat cause of chronic pain; previously called reflex sympathetic dystophy). The last one fits the symptoms the best so they plan on treating him with spinal stimulation. When they talk to Vince, he tells them that he has been doing research online and believes that he has mercury poisoning. To placate him, Thirteen draws a mercury level. It is mildly elevated, but nowhere near the toxic level. Nevertheless, Vince still believes that he has mercury poisoning and demands chelation therapy. Foreman steps up and draws the line, informing Vince that if doesn’t want to follow his doctor’s advice, he can do so elsewhere. Vince grudgingly agrees to the spinal stimulation.
The stimulation provides no improvement, and during the procedure, Vince develops a racing heart rate and flash pulmonary edema (the lungs quickly filling up with fluid). Further study demonstrates that Vince has a thickened left ventricle (part of the heart). Lyme disease and cocaine use are the new differential diagnosis. Lyme disease doesn’t quite fit, and Vince denies any cocaine use. Not entirely trusting him, Thirteen and Taub search his office. They find no cocaine, but seeing the realistic rendering of birds in his game, Thirteen suspects he has been in close contact with them and developed psittacosis (also known as “parrot fever,” a disease carried by birds than can be passed to humans). As the team is telling him about the disease, Vince mentions that he is suffering from priaprism — a persistant erection — for the past three hours. The priapism not only requires surgical correction (a shunt), but it also rules out psittacosis.
The new differential diagnosis consists of Guillain-Barre disease (an autoimmune disease of the nerves), thrombocytosis (a disease caused by too many platelets), or a brain tumor. Thirteen favors the tumor diagnosis, but Foreman presses ahead with thrombocytosis, despite Vince having a normal platelet count. He wants to start Vince on hydroxyurea (a medicine used to treat thrombocytosis). At this time, Foreman and Thirteen notice two other doctors — doctors that neither of them recognize — standing next to Vince’s bed. It turns out the other doctors came in response to Vince’s internet postings. Foreman reminds them that neither of them are credentialed to treat patients at Princeton Plainsboro Hospital. One doctor turns out to be a quack, but the other seconds Thirteen suspicion of brain tumor. Vince demands an MRI and Foreman agrees. When the MRI shows no sign of tumor, Vince is started on the hydroxyurea.
Instead of improving, Vince develops massively enlarged cervical (neck) lymph nodes. This should not happen in thrombocytosis. He is started on steroids, which bring down the swelling. Foreman suspects polyarteritis (an autoimmune disease of the arteries), but before the team can act they discover that Vince has posted all his symptoms online and is offering $25,000 to whoever can diagnose his condition. The diagnostic team is inundated with faxes, calls, and e-mails. They confront Vince and tell him that it will take way too long if they have to address every one of the online suggestions (samples include paraneoplastic syndrome, Graves disease, and demonic possession). Vince tells them that he thinks he has amyloidosis, since that’s what most of the people on his site are saying. Foreman agrees to biopsy one of his kidneys looking for amyloidosis, but only if Vince agrees to shut down his website and rescind his reward when the biopsy is negative. Of course, the biopsy is “suggestive” of amyloidosis, and Foreman starts him on dexamethasone (a steroid used, among other things, to treat amyloidosis).
The story isn’t over yet (clearly, as it is has only been 45 minutes), and a short time later Vince is running wild through the halls of the hospital, feverish and hallucinating. Antipyretics (fever reducing medicines such as Tylenol or Motrin) have no effect, so he is placed in a cooling bath. Foreman tells him that Light Chain Deposition Disease (the body overproduces the light chain — part of the antibody macromolecule — and it is deposited in various organs) is the most likely diagnosis, and he will require high dose chemotherapy for treatment. Wearily, Vince agrees. Just as the therapy is about to start, Foreman has his Aha! moment when he realizes that Vince’s fingers never became wrinkled in the bath. This is a sign of Fabry’s disease, a condition caused by the errant deposition of certain lipids throughout the body. His elation is short-lived, however, when he discovers Thirteen has already made the diagnosis and started treatment, based on an internet suggestion she read behind Foreman’s back.
As the episode ends, Foreman is officially put in charge of the team — what little team there is left. Taub has quit to take a surgical job and Foreman just fired Thirteen because he feels he can’t be both her boss and boyfriend. To further complicate matters, House has realized that difficult diagnostic situations are the only thing that keeps his mind off his leg pain and decides to come back to the hospital (after all, it was his suggestion of Fabry’s disease that Thirteen unknowingly used).
I found the medical aspect of the story to be rather uninteresting this week, but whether it was from the weak mystery or lack of House — or both — it’s hard to say. The medicine was haphazard, jumping from diagnosis to diagnosis and lacked the drive most episodes have. Still, there was some logic to it, just not much. Because there wasn’t much medicine, there isn’t much to criticize.
As usual, major complaints are in red, minor in blue, nit-picking in green:
I am concerned that the pathologist could not tell the lipid depositions of Fabry’s disease from the protein depositions of the LCDD and Amyloidosis.
The team couldn’t make up their minds whether to play hard with the diagnostic criteria (no joint pain, can’t be Lyme), or loose with them (sure, you can have thrombocytosis — a disease defined by elevated platelet counts — with normal platelet levels). A little consistency would be nice.
Shouldn’t abnormal lipid deposition in the nerves showed up on a nerve conduction study?
There was nothing about this patient’s initial presentation that required inpatient admission. Almost all the work-up, including the nerve conduction studies, should have been done as an outpatient.
While spinal stimulation seems to offer some relief in many patients with CRPS, it is does not work for everyone, and is generally not the first treatment tried.
The medical mystery was only modestly interesting, and never developed the “this guy is on the verge of dying” feeling that makes these shows interesting; I give it a C. The final solution was logical, and generally fit the symptoms so earns an B+. The medicine was stumbling, and seemed to arbitrarily ignore as many logical diagnoses as it focused it; at best, it was average: C. The soap opera, though predictable, was well done and also earns a B+.
Last week’s House review
A list of all prior House reviews
September 28th, 2009 at 10:43 pm
First-time poster, long-time lurker.
I can’t believe they finally titled an episode “Epic Fail”. Oh well, truth in advertising for once.
September 28th, 2009 at 10:51 pm
It will probably be a slow few episodes where they establish new rules before the show takes off again. Glad to see the Pscy Doctor back.
September 28th, 2009 at 11:05 pm
My favorite part of the episode….was the preview for next week’s and House’s line. *sigh*
September 28th, 2009 at 11:08 pm
Best episode title ever. Epic WIN!
The concept for the episode and the CGI hallucinations deserve alot of credit on their own. The novelty of it makes me like this episode.
September 28th, 2009 at 11:09 pm
Polyarteritis from enlarged lymph nodes? I’m not convinced… Also, I agree with the major red comment – even the stains are different between fats and proteins – that was definitely the odd leap this week.
September 28th, 2009 at 11:32 pm
An ok episode. I hope Andre Braugher comes back as a guest throughout the season. I think the House/therapist sessions are the most interesting thing so far.
And, coming from the video game industry, I found the portrayal of game developers to be typically, hilariously wrong. It reminded me of the late-night TV commercial about getting your degree in game design where the workers just needed to “tighten up the graphics on level three!”
September 28th, 2009 at 11:35 pm
I thought this episode was great. :)
September 28th, 2009 at 11:38 pm
While House’s online solution led Thirteen to the solution, Foreman did actually solve the case on his own through his House-like “Aha!” moment. It was good to finally see Foreman succeed at this, given that every other time he’s tried being the boss he’s crashed miserably.
September 28th, 2009 at 11:40 pm
I got the feeling that this episode was a bit weak, starting an episode in a CG computer game with a bunch of talking animals (albeit cool in the video game world) just seemed to be the Special Effects department showing off. I agree that almost every scene that House wasn’t in were very dull.
September 28th, 2009 at 11:42 pm
I predicted this last week, but it was still nteresting to see Foreman’s power grab at Princeton Plainsboro….the title of this ep is fitting, “Epic Fail” indeed for foreman, both in his professional AND personal lives… Lol
He should have known better then to think he makes a better House then….House. Even Cuddy noticed his lack of tact by jumping all over House’s job before he had even cleared the exit doors…. O_o
This ep and it’s focus on the Foreteen drama made it a meh episode for me…. Taub’s quitting (and presumably leaving the show?) made for a small bit of ‘whoa, didn’t see that coming..’ that lasted for about all of 3 seconds.. Will he REALLY quit w/ House coming back next week??
And what was up with Chameron? they basically only had 5 or 6 lines between them the whole ep… Wilson had more lines and that was only b/c he lives with House….
An episode that felt like filler, looked like filler and set the stage for House getting back to what he does best starting with next weeks episode…
Gonna be fun watching him but heads with foreman, especially when House finds out he fired Thirteen the week before
September 28th, 2009 at 11:42 pm
Sadly mimicing an episode I had been hoping for, I really would love to see a techy version of House go toe to toe with him.
I liked the cooking scenes.
Andre Braugher is an incredible actor and they have him in character that makes sense in the series. He will bring a nice touch to this season. I just hope they don’t fall into the trap of making him the POTW.
September 28th, 2009 at 11:43 pm
Good episode – I really enjoyed the House bits, particularly the cooking segments (”Why does this missionary dress like a hooker?” “I was talking about the position!”)
I’m not a doctor, so most of what I know, I’ve learned from watching House. I read this website to see what a *real* doctor thinks about the medicine, but it wasn’t too bad this week.
The one thing I didn’t think was very realistic was that Vince was trying to call all the shots. Whatever happened to listening to what the doctor has to say, instead of fighting him all the way?
September 28th, 2009 at 11:43 pm
This must have been discussed before… the guy has legitimate medical pain. Why not let him use the pain reliever? Except get him off the acetaminophen, that would make him really sick and it’s unnecessary. Plain oxycodone is a much safer drug than the acetaminophen combos. I think this is a puritanical trap that is keeping that plot line running… or is it just a product placement deal to stimulate popular desire for Vicodin Brand? The acetaminophen is the dangerous drug here.
September 29th, 2009 at 12:02 am
Yeah, the writers didn’t let themselves to get shied out now and are really moving on to change some things. I think the show can only improves from now on… High hopes on season six here.
And what about this “Cameron is going off in november” stuff that’s about the net? Maybe they are pushing this “changes” thing a little bit too far….
September 29th, 2009 at 12:16 am
This episode was definitely better than some of you are complaining. There were many good House lines that had me rolling on the floor. The Taub/13 team breaking up should have been the best part of the episode since all I’ve heard from the last two seasons was how terrible they are. Yes, the parts of the diagnosis that didn’t involve House were chaotic and dull but I think they were supposed to be. If they made a TV show starring Omar Epps as a mediocre Diagnostician barely making it through cases and constantly having self doubt and personal issues, no one would watch it let alone make a website about it reviewing each episode. Sometimes I think people complain….just to complain.
September 29th, 2009 at 12:46 am
I am still so confused as to why House is in therapy for *depression* and not, say, Borderline Personality Disorder. I guess depression is popular these days? (Also, his hyperfocus on a single activity when he then tires of after a period of intense interest reminds me a lot of how my ADD manifests, though I guess it then makes a better case for depression, since I tend to to that when I’m avoiding things related to my depression/anxiety.)
Medical mystery dull, soap opera acceptable but not as funny as it could have been, and for fuck’s sake, there are non-narcotic pain killers stronger than ibuprofen.
(A question, somewhat out of the blue – I was watching with my mother, and when the patient’s lymph nodes blew up, I turned and asked her if she remembered when I was eight and we went camping, and I got bitten all over by mosquitos, and the lymph nodes in my neck swelled up so much the doctor was rather impressed, which of course she did remember, so I asked her what it was I actually had, and she claimed nothing, it was just a reaction to the bites. While I am pretty highly reactive to mosquito saliva, I’m a little bit skeptical that that could be the sole cause of such a reaction. Could it?)
September 29th, 2009 at 2:16 am
Hey Dr. Scott,
2nd year med student here and I just wanted to say thanks for the reviews. I’ve read all of them and I’m a huge House fan. I think you’ve taught me more than most of my professors. Thanks again.
September 29th, 2009 at 3:11 am
@Micaelm
As a chronic pain patient and as a soon-to-be alcohol and drug counselor, I’ve given what you brought up a considerable amount of thought throughout the duration of this series.
In the past Scott has demonstrated that House showed signs of pseudoaddiction rather than addiction (the former mimics the symptoms of the latter until the patient reaches adequate analgesia).
Its really a grey area if House is technically an addict or just physically dependent. The writers seem to make no distinction between the two but many drugs that possess no recreational value can produce tolerance and withdrawal upon abrupt cessation (some notable examples are OTC oxymetazoline nasal spray, venlafaxine and other SS/SNRI’s, antinconvulsants and even OTC analgesics like acetaminophen or ibuprofen can cause rebound headaches).
I don’t necessarily agree with show’s reasoning, but it seems that since House was abusing his medication (regardless of whether he was getting high, he was forging prescriptions, asking multiple doctors, taking more than he FDA limits of acetaminophen presumably, etc.) they deem him an addict. If we assume he is then it pretty much has to be all or nothing because he won’t be able to take his medication appropriately and just limit himself to that. (for further information look into the disease model of addiction)
If we take the opposite view that House is only a pseudoaddict then I completely agree with you; if his pain is managed appropriately then his “addict” behaviors will vanish.
It seems that since the writers do not distinguish between addiction and physical dependence, they use signs of pseudoaddiction to justify labeling him an addict and therefore disease model concepts of “all or nothing” come into play.
To further complicate things, even if House is an addict doesn’t he deserve pain management? There are many treatments out there that can be beneficial that are non-narcotic. Some examples include tricyclic antidepressants or the newer SNRI’s, anticonvulsants like pregabalin/gabapentin, the unscheduled tramadol (although this does effect opiate receptors I believe it agonizes the Mu receptors at about 1/32nd the affinity of morphine and derives much of its analgesia from its SNRI properties) and still other possibilities.
Another option is buprenorphine (brand name Suboxone or Subutex). This drug is currently being used very similarly to methadone in Opiate Replacement Therapy (maintenance) or in tapering off painkillers or heroin. As a partial agonist it will produce some analgesia (not as much as full agonists like vicodin, heroin, oxycodone) and has the added benefit of blocking the effects of any other painkillers for 24-72 hours after administration of a sufficient dose. This may not be AS effective for his pain, but it is likely better than nothing.
In summation, I think that the show has handled his pain management and drug use very poorly reinforcing inaccurate stereotypes, blurring definitions and sensationalizing.
September 29th, 2009 at 3:26 am
It’s kind of interesting to me that last season opened with Wilson deciding he needed to leave Princeton-Plainsboro to heal and in the second episode of this season, House decides the same thing. The big difference is that it took less time for House to return to the hospital than it did Wilson.
Personally, if I was a doctor who had a patient like Vince – one who trying to diagnose himself over the Internet, I don’t think I’d be as willing to keep him as a patient. I’d definitely be a bit insulted. This does lead me to a question to ask the real doctors out there – Has this sort of thing become a common problem? People diagnosing themselves over the Internet?
Vince was expecting House to be in charge of his case. Instead, he got Foreman and his team. Wonder why Foreman didn’t try to reassure Vince by pointing out how long he’d trained under House?
September 29th, 2009 at 3:48 am
I thought it was brilliant! I really enjoyed it. Thanks for the medical review as usual.
September 29th, 2009 at 5:04 am
I guess the leap impliedly taken by House was to exclude enlarged lymph nodes as a symptom, attributing them to a reaction to the contrast used in the MRI that Foreman didn’t want.
September 29th, 2009 at 5:21 am
Saw some pics of the next episode…Will the good old crew be back?
Btw. Awsome reviews, let’s hope for an awsome season.
September 29th, 2009 at 6:01 am
“2nd year med student here and I just wanted to say thanks for the reviews. I’ve read all of them and I’m a huge House fan. I think you’ve taught me more than most of my professors. Thanks again.”
Should we be worried? Just let me know if you decide to practice pediatrics in HK. ;)
September 29th, 2009 at 6:30 am
I thought the CGI was an interesting twist and that the dullness of the diagnosis was intentional and reflective because of the absence of House.
House in an apron cooking: epic classic.
I have to admit that I didn’t see it coming that House would solve the case by finding it online, maybe the lackluster of the episode dulled my wit?
September 29th, 2009 at 7:28 am
In this episode it was revealed that House is using Ibuprofen for his leg. I don’t know but going from Vicodin to Ibuprofen seems implausible.
I think Taub will be back once House is back but Cameron will be leaving the show mid-season.
September 29th, 2009 at 8:15 am
Wasn’t house supposed to be taking up a research position? What of that?
September 29th, 2009 at 8:27 am
House is letting his inner Sherlock Holmes out. What is house but a medical Sherlock Holmes?
Remember Sherlock Holmes had a cocaine addiction that he was only able to master when he was working on a case!
I hope the Sherlock aspect and medical mysteries become the focus of the stories.
September 29th, 2009 at 8:39 am
Hi there! An enjoyable episode though a bit dull at certain moments. Probably most amusing was that (apart from House) Taub was the one making jokes all the time. Peter Jakobson is the one I’m going to miss if the whole “new team” idea is finally destroyed. Anyway since I do not know much about Fabry’s disease I’ll restrain myself from commenting the medicine. One thing to note is that because Foreteen was (mostly) in charge they did not do too much jumping from diagnosis to diagnosis like they usually do with House. The producers seem to drop the ball regularly now (that is probably why d-r Scott doesn’t even bother mentioning it anymore) but here is an example of non linear non medical thinking – the patient develops swollen lymph nodes but not any others acute allergic symptoms (part of the whole Quinke syndrome) However the team immediately decides it’s some sort of allergic (I won’t say autoimmune!) reaction and put him on steroids. What if it was a sigh of infection? The steroids would suppress his immune system and he may develop sepsis. But now let’s follow through! New differential? Amyloidosys. Treatment – dexamethasone – a steroid. I would have been truly baffled if that was not something usual in House now. Apart from the usual “not really thinking it through” medicine it was an enjoyable episode and the part where House was messing up with Wilson (and Cuddy) was really hilarious. So thumbs up to Hugh Laurie again and let’s wait for the REAL House to start (hopefully from the next episode)
September 29th, 2009 at 8:41 am
I asked before I’ll ask again – does anyone knows something about the whole rumor “this is the last season of House with only 15 episodes overall” thing?
September 29th, 2009 at 9:04 am
My local FOX network ruined the Cuddy/House/Chef moment with their ads, which would have been hilarious if I hadn’t known she already spoke English.
No background in medicine, but they seemed to hit it hard halfway through when Vince started calling the doctors in. Of course, that doesn’t mean they were right.
Basically a comedic/padding episode, as far as I can tell. Next week should probably be better.
September 29th, 2009 at 9:16 am
@ SquishyCat
Speaking as a psych graduate, borderline personality disorder (or any personality disorder) is not generally treated medically, as far as I know. Personality disorders are sort of considered “untreatable” because they’re not really diseases but maladaptive personality types. Instead you might treat symptoms medically (with antidepressant or antianxiety drugs) and use therapy to develop coping skills or adjust the person’s lifestyle to suit them better.
In that sense I thought this episode was much better than last. Though I don’t think he has a personality disorder at all. (Basically he’s just not screwed up enough.)
I agree that House probably has ADHD, probably combined type, though it’s hard to say for sure because opioid intoxication, depression, and pain all can cause restlessness and trouble concentrating. We’d have to see what he was like before his pain started (and preferably see what he was like as a young kid). The persistent boredom, avoidance of the boring parts of his job, multiple hobbies, and hyperfocus are a big clue, though. Impulsively blurting out whatever rude comment comes into his head is another (and I do like the rationalizations). Addiction, depression, and relationship troubles are all common in people with ADHD.
(Then there’s the theory that Sherlock Holmes was self-medicating his ADHD with the cocaine…)
September 29th, 2009 at 9:19 am
Hi,
I haven’t seen all of the episode, so I probably just missed it, but what was the solution to House’s dog urine in Wilson’s toilet? Was it just him messing with Wilson and Cuddy?
September 29th, 2009 at 9:24 am
I really found this episode entertaining. The “you saved my balls” part was great, as also was the Cuddy’s i’ll miss you part. The problem between Foreman and thirtheen was algo great. I hated foreman’s satisfaction face when he was taking on House’s office. I think House deserved a little more respect at that point.
Taub’s resignation, well, what the heck. “I’m in, i’m out, I’m in, I’m out”…
The guy using the Internet to find what’s wrong with him, so typical. But this guy takes it a little more serious than he should.
If it’s true that this is the last season of House, then i hope the writers make the last episode an awesome one, because if they don’t i’ll hate them for life.
I liked the episode…
Heishiro
September 29th, 2009 at 9:35 am
D-r Bulgaria: the article “List of House Episodes” on Wikipedia says that Season 6 will consist of 22 episodes, and says nothing about it being the last season.
September 29th, 2009 at 9:44 am
SPOILER WARNING!!!
There’s also a Wikipedia page called “House (Season 6)” which has a lot more info on the season, including summaries of episodes that have not yet aired, and recurring character information that might give away things you’d rather not know ahead of time.
SPOILER WARNING!!!
September 29th, 2009 at 10:30 am
Another “unhouseian” episode, yeah! But at least we´re back at PPTH and have a regular case. House living with Wilson was really funny.
1. I don´t believe House will stay quit, Foreman in charge, Thirteen fired and Taub gone.
2. What actually caused the fever? Don´t think it was Fabry´s…
3. Calling the docs in after an online consult?? Can´t imagine that!
4. Loved to find out the final online solution came from House:-)
September 29th, 2009 at 10:38 am
House will open a successful restaurant with the $25,000 reward for the correct internet diagnosis as seed money and the Franka Potente character comes back to him to help out in the kitchen and the bedroom. House does medical consulting as a side business for additional income. And lives happily ever after. Or maybe this will have to wait for the final episode.
What the show seems to lack is more hunour and playfulness.
September 29th, 2009 at 11:32 am
This episode really showed how essential Hugh Laurie is to the success of this show. This episode was just boring without him on camera.
September 29th, 2009 at 11:46 am
How many times have we seen the “Foreman’s in charge” story, and nothing ever changes? The writers are clearly burned out, fire them and hire someone with fresh ideas.
Do I understand correctly that Foreman thinks the best way to keep 13 as his girlfriend is to fire her (because if they keep working together they’ll argue and break up)? Uhhh…good luck with that one.
I like the idea of using the Internet to tap the collective wisdom of the masses. Obviously, you’d have filter out the crackpots, but if Foreman had a little less pride he could use this tool to compensate for not being a genius.
September 29th, 2009 at 12:19 pm
In the scene where Vince is hallucinating in the lobby, all the doctors, nurses, and people are just passively staring at him, while he is all feverish throwing coffee at people. Shouldn’t the doctors be doing anything, even if it is just calling in a “code -”, checking his temperature, or talking him down?
September 29th, 2009 at 12:44 pm
This is excellent way to get rid of Taub and 13 and to get back to old team and to House doing what he does best. And the episode ending was great.
September 29th, 2009 at 12:52 pm
@D-r Bulgaria, @John H: The last I heard, Hugh Laurie has contract for seasons 6 and 7, and most likely will sign a new contract for more seasons. And FOX is not going to shut down their most successful show any time soon. So, no worries, House is here to stay.
September 29th, 2009 at 1:59 pm
I’m too burned out from work today to bother a Deconstruction post about it, but , but the VR portrayal was a little unrealistic. (ex: Not enough motion/positional sensors to produce the kind of one to one motion seen in the game.)
September 29th, 2009 at 2:51 pm
I thought this whole episode was just too convenient for plot progression. Maybe I’m still a stickler for the old takes forever kind of dramas. I just think the whole Taub quitting with no reason, and then 13 being fired was just something that should have taken place more or less on a 2 episode basis. Its like the writers were focused on “Get the young guns back, screw the medical aspect” for this one.
I do think the screw ups that happened shedded some light on just how hard House’s job is for the team though. The whole conclusion was just too quick for the last act though. Pretty soon House will be a 30 minute nightly show at this pace.
September 29th, 2009 at 2:52 pm
I loved this episode. I think the C.G.I. scenes were a cool cinematography departure, and I liked the patient a great deal. Any scene with Hugh Laurie will of course be great, and I am ignorant enough of medicine to still be enthralled by the medical scenes.
I swear the writers of the show troll this site. I think amyliodosis winning the online poll was a jibe against us all, and I think the title of the show was a Red Herring. (Really, who failed epically?)
Anyone else thought that House was spiking the Ragu? What self-proclaimed great cook ever uses freakin’ Ragu unless it has opiates in it? Seriously.
September 29th, 2009 at 3:06 pm
Official Comment
It wasn’t Ragu, the brand-name mass-produced tomato sauce, but ragout (according to the closed captioning), a French style of meat stew.
September 29th, 2009 at 3:16 pm
Did she knew?
Thirteen went thru the emails and found one that made sense. Did she knew it was from House? Because later he received a cheque for the correct diagnotic.
September 29th, 2009 at 3:34 pm
I thought the VR was cool and the medicine seemed iffy, but that shows I know nuffin on both subjects I guess. But I did find this about the ragu-stuffed unhatched eggs on crackers:
http://www.nytimes.com/2007/02/07/dining/07eggs.html
I thought that whole sequence was amazing.
I do seem to recall that House has tried to be better and happier from time to time (notably beginning of Season 3 but even in spurts in Season 5) and it never lasted.
September 29th, 2009 at 3:56 pm
The cheque was given out by the techie not PP, so its plausible none of the medical staff know it was House, unless he sent it in using a known email addy.
I would totally watch a House:Iron Chef series. And I love the presence of Andre Braugher. He’s a great actor, underused since Homicide:Life on the Streets.
September 29th, 2009 at 4:05 pm
I thought it was a pretty cool episode. I think the writers are really playing with things this season. The animation scenes were great – something new and very dramatic. Also, I like how the character of House is getting more and more complex. I think it will be cool to see how Wilson and House’s friendship evolves if House becomes more socially appropriate. Will Wilson lose interest if fixing House isn’t a project anymore? Hopefully the writers will find more ways to incorporate the biting wit that makes House so interesting.
September 29th, 2009 at 4:36 pm
@Harvey and Scott
I think it was ragù, Italian meat sauce (pork sausage and shin of beef?) simmered for a long time. It looked red on the spoon so it had a tomato base, and it was sufficiently liquid to be injected using a syringe. A proper ragù (or ragout) ought to be chunkier, I think, but I guess that if the point was to inject it rather than dump it on pasta one might strain it..
But of course it wasn’t supposed to be bottled Ragu brand spaghetti sauce. Though that is what it looked like.
September 29th, 2009 at 4:54 pm
It’s funny about the people who liked the VR scenes. I’m not criticizing those people, mind you, we all have different tastes and criteria, but If I were giving the episode a technology grade, (using a scale intended for non-sci-fi material) I’d give it a C- for the VR scenes.
September 29th, 2009 at 5:32 pm
Seemed like we learned that a show called House, for obvious reasons, needs House.
Thanks as always for writing the medical review, especially on an episode that may not fully deserve your careful attention. They need to make it up to you!
September 29th, 2009 at 5:55 pm
@ Harvey:
“I think the title of the show was a Red Herring. (Really, who failed epically?)”
Umm Foreman failed epically…. He not only failed in running the PP Diagnostics Department, he caused 2 members to leave (Taub left b/c Foreman’s no House but will probably be back when House is and 13 because he’d rather fire his girlfriend then fight with her making decisions that contradict his role as leader of the team), broke up the Diagnostic Department to the point where Cuddy may reassign those who remain again anyway, AND he may have permanently screwed up his relationship w/ 13 b/c of the firing… Not to mention he failed publicly when a patient clowned his decision making abilities by posting his case on the internet and looking up his medical practice history to use against him… word about this has probably already spread through the medical community, thus diminishing his public reputation and confidence in him as a top tier Doctor..
So Foreman hit the “Holy Trinity” of Epic Failures this week: Professional, Personal and Public…. Hopefully his Ego will be taken down a further notch (or 3) when House is back next week and he presumably needs to step aside for him.
I’m glad they’re exploring the House vs. Foreman angle again, this time to it’s hopeful conclusion… Either Foreman can or can’t be a team player (and will stay or leave based on what he feels he can do) but he’s proven by his blunders and missteps this week that he’s not cut out ‘for the big chair’ and Cuddy was very justified in having those feelings of apprehension she expressed to him at the beginning of the episode.
September 29th, 2009 at 5:59 pm
I’d just like to thank John H for posting a simple spoiler warning, it allowed me to miss out his post, and save any spoiling from occurring. A courtesy most posters on here don’t afford, which is very unfortunate, because coming across unwanted spoilers really does ruin the suspence and build up of the series.
September 29th, 2009 at 6:45 pm
I think you might have mixed up thrombocytosis (elevated platelet count) and thrombocytopenia (reduced platelet count) towards the end of your summary but a good review nonetheless. As for internet medicine……the writer’s are really trying hard but have unleashed a clue as to why the show’s medicine is routinely poor. They’ve fired the consultants and are now using the net themselves. Finally amyloidosis from enlarged lymph nodes? Didn’t they used to throw sarcoidosis as a differential at that symptom?
September 29th, 2009 at 7:37 pm
What did the quack say that Vince immediately dismissed with, “Okay, that guy’s an idiot”? I didn’t catch the line.
The medical scenes were indeed dull this episode, but they didn’t have to be. The writers just brushed over the potential conflicts between the three team members. But I was overjoyed to see the old team will be back next week.
September 29th, 2009 at 7:53 pm
While I liked the original team that House had, I was glad that they broke up. I much prefer Cameron in the ER. It seems to play to the strengths of her character rather than her lost puppy attributes (oooh… pleeease take me hooome with yooou. . .). I also way prefer Chase in surgery. He really rocks there and is willing to stand up to both Cameron and House in a way that he did not while on House’s team. Foreman as a character does not have a sense of humor and takes himself way too seriously. 13 takes herself too seriously and also was more fun when she wasn’t seeing Foreman. Taub is great. I like him. His character actually has some dimensionality and he has a life offscreen. If they hadn’t killed Amber and Kuttner (since they’re both dead are they Kamber?), the producers could have brought them back later. So I think that House needs a new team (and please, no more reality show stuff. That sucked).
September 29th, 2009 at 8:17 pm
I enjoyed this episode. The virtual reality sequences were entertaining, and I loved the fact that House solved the case and won the $25,000. I should have seen it coming, but I didn’t. The satire on patients’ overdoing it with the internet was probably appreciated by many physicians. I agree that the medicine was mediocre, but it wasn’t horrendous. I hope the Thirteen/Foreman romance is over–it never appealed to me, and last night he showed himself to be an insufferable, self-centered creep. She should have slugged him for firing her. I think both Thirteen and Taub will be back for the rest of the season. Now that House has returned to the hospital, too, I have high hopes that the show will go back to being as good as it was early on, before his drug use became so debilitating and extreme.
September 29th, 2009 at 8:20 pm
i thought chase and cameron are back this episode!
September 29th, 2009 at 8:21 pm
Hopefully, they’ll fix the Taub and Thirteen thing soon. Axeing them like that is basically saying the last two seasons were pointless. S4 and S5 already get enough guff.
September 29th, 2009 at 9:40 pm
@ rowell james bautista, RN”
“i thought chase and cameron are back this episode!”
“Chameron” was…. if you consider 10-12 lines of dialog between the 2 of them the entire episode being ‘back’….
No mention of their wedding at all.
@ B:
“Hopefully, they’ll fix the Taub and Thirteen thing soon. Axeing them like that is basically saying the last two seasons were pointless”
Did you see the teaser for next weeks ep? Chase, Cameron and Foreman walk in to Houses office and see him sitting there in his Grey suit and the newly clean shaven House looks up at them and says “Oh my god… its 3 years ago. Does that mean I’m still crazy”?
Hmmm……. :)
September 29th, 2009 at 10:03 pm
I actually have a question about last weeks episode: What artist did the opening song?
I cant get the chimes/glock from the opening out of my head after watching it again earlier today for the 8th time…
September 29th, 2009 at 10:24 pm
@ luke: “What did the quack say that Vince immediately dismissed with, “Okay, that guy’s an idiot”? I didn’t catch the line.”
He wanted to sell him a 1-month supply of some sort of supplements for $395.
September 29th, 2009 at 11:26 pm
@ Princess Edamame: “I can cure all your symptoms with my Papaya Toxin Cleanse. A months supply $395″….
September 29th, 2009 at 11:42 pm
There are no such thing as stupid questions … except for this one.
Wilson had said that he found epithelial cells in House’s urine (turns out to be urine from a dog). If I’m not mistaken, epithelial tissue (made up of epithelial cells) function as a layer around organs (visceral epithelial tissue) or layer covers cavities (parietal epithelial tissue) … and also epithelial tissue makes up the skin.
My question is how can epithelial cells be found in urine? Does the epithelium tissue of the urethra slough off like skin even though it is not keratinised?
September 29th, 2009 at 11:56 pm
@ neuroscience undergrad
I can’t answer that question (my guess is some skin cells mixed in, since they’d be in the dog’s fur and dogs have fur everywhere), but I’d like to know how they found out it belonged to a Labrador. Seems like kind of a specialized DNA test would be required, when the required information is just “not House and also not human.”
Also from what I understand of toilets whatever was left in the trap would be extremely dilute. That whole thing really made no sense, actually.
September 30th, 2009 at 1:06 am
@Bryan
Vince’s domineering behavior is, sadly, becoming more and more accurate. It’s not that uncommon now for people to go to a doctor with a diagnosis already decided for them by their internet research. If the doctor disagrees, it’s a simple matter for the patient to just find another doctor who’s willing to patronize them. This is especially true in the case of parents deciding that their kids have ADHD, but it happens with all sorts of other things. Granted, it’s probably not as common when people have a legitimate, life-threatening ailment, but it’s still closer to reality than is comfortable. Now, to be fair, sometimes the patient is correct or may have some useful insight, but that’s the minority of cases.
September 30th, 2009 at 2:08 am
@ Hugh L: The song you’re talking about was ‘No Surprises’ by Radiohead, available on their ‘OK Computer’ album.
September 30th, 2009 at 4:04 am
Epithelium sheds everywhere – it is that kind of tissue as a structure – it has base, non-diferentiated cells and mature cells and the base periodically replace the mature ones(the base cells are deep inside and the others are near the surface). There are many different types of ephitelium, some of them lose and replace cells every day on a regular basis (mouth, skin) and other types that are highly specialised and do not get replaced unless damaged in some way (for example the epithelium inside the trachea has special protrusions hmmmmmm I do not know the word well sort of like hair that catches the dust and moves it out of the body it can get damaged and replaced due to chronic inflamation from bronchitis asthma or smoking. But the basic rules are the same. I am unsure however how often they erode form the ureter tract or if they even do under normal conditions. As for the test the urine from inside the toilet or find out exactly what kind of dog peed inside – cudos. It was VERY unbelievable but incredibly funny so I liked it.
September 30th, 2009 at 5:29 am
@ Marziepanic : Thanks for the song info…. it’s appreciated! :)
September 30th, 2009 at 8:35 am
Official Comment
When we do urine tests in the office, we have the patient wipe first, and then do a mid-stream urine (i.e. wait a few seconds, then collect the sample). This is done to limit the risk of contamination of the sample by normal skin bacteria.
When we see epithelial cells in the urine sample, it tells us that it was not a clean catch sample (or no good wiping beforehand), and is probably a contaminated sample. (So the epithelial cells are basically contaminants from the skin).
In House’s case, it wasn’t a clean catch urine, so of course there would be epithelial cells. Not to mention that they’re heavier than other urinary elements so would collect in the trap. Seeing epithelial cells in a sample like Wilson obtained is, frankly, expected — and doesn’t mean what the show makes it out to be.
September 30th, 2009 at 8:58 am
I think, like others here, that the sloppiness and apparent insecurity of the team is consistent with the story. I mean, they lost House, so they are sort of lost themselves. Foreman’s ego is not enough to match House’s genius.
September 30th, 2009 at 11:12 am
Hi, all.
I really enjoy Scott’s recaps and analysis of the show and it’s medical accuracy. I also enjoy reading all the comments; they are most enlightening.
I’ve never really been able to add anything constructive to the discussions, but today I ran into an article that goes a bit deeper into the technical aspects of the C.G.I. scenes if anyone is interested in that aspect of the show:
http://www.studiodaily.com/blog/?p=2036
Thanks for the insight and comments; I always look forward to reading them after a show airs!
September 30th, 2009 at 11:30 am
Self-diagnosis on the internet: DONT DO IT.
I had a bulge in my naval looked it up and it kept pointing to stomach cancer, that and losing a few pounds from the week before played on my mind so I was convinced I was “Dead man walking”; it was the longest day of my life waiting to see the doctor that evening, how the hell was I going to tell my young daughter, etc. etc. etc. When the doctor told me I had a hernia, it was one of those situations that the sense of relief, almost makes the stress worth it.
September 30th, 2009 at 11:50 am
Why is House living with Wilson? His own apartment is still there. All his stuff is still there. Somebody’s paying the rent on the apartment and has been since House first went to Mayfield.
So why isn’t House using his own home? (It’s also a shame nobody went to the apartment to check it for Vicodin while he was in Mayfield. Somehow, it never occurred to anyone to check to see if he had any Vicodin stashed away?)
I guess House and Wilson did make up since “Broken, part 1″. This really makes me wonder why Wilson did not visit House at Mayfield and why Wilson, at least, didn’t pick House up when House was discharged from Mayfield?
September 30th, 2009 at 2:22 pm
@ Benn:
“Why is House living with Wilson? His own apartment is still there. All his stuff is still there. Somebody’s paying the rent on the apartment and has been since House first went to Mayfield. So why isn’t House using his own home?”
Wilson is presumably there to watch House and keep him from using… kinda like a big brother to an Alcoholic..
I’m willing to bet that up to the time he ‘quit’ Cuddy had House on paid leave, because she thought like everyone did at the time that he’d be coming back at some point… 3+ months of House’s salary would pay the rent on his place for years…
You ARE right tho sloppy for House to have been able to ’stash’ his drugs at Wilson’s place for an emergency.. *Common Sense* would have dictated that ANY place House was going to live be completely searched for contraband before allowing him to live there or at the least, as a condition of his release from Mayfield…
I guess no drugs would have made the fact that solving Diagnostic Cases makes his leg pain vanish seem somehow less believable if he didn’t have the temptation in his face…
September 30th, 2009 at 4:56 pm
@ Scott (and others):
As a veterinarian, we generally used cystocentesis to get urine samples. It is a rare dog that will allow a mid-catch sample (no cat will do that). Speaking as a doctor who treats more than one species, you would not be able to tell from the cellular analysis of a urine sample that it was a particular animal (much less a particular dog breed). On the other hand, some animals do vary from humans on the chemical analysis. Hopefully that makes sense.
On the other hand, if Wilson just happened to treat House like House treats others and did a genetic analysis, then he might be able to tell that it was a dog (I doubt if he would be able to get as far as labrador).
My immediate thought about this (while watching the show) was that there would be an incredible amount of chlorinated water mixed with the urine, so how was it analyzed?
September 30th, 2009 at 5:58 pm
I had a really hard time believing that epithelial cells can be identified as species-specific, even breed specific.As a veterinary technician I see them all the time and I can’t tell a dog epithelial from a cat’s. I’m not too sure any pathologist could lookthrough a microscope and say, “yup, golden retriever”.
September 30th, 2009 at 7:38 pm
@ Scott
You are much smarter than my anatomy professor hahaha … naturally
September 30th, 2009 at 8:51 pm
@Hugh L. The bottle of drugs House found was back at his apartment. There was a lot of dust and the power was out. They were hidden in the shoe like he told the hallucinatory Cuddy at the end of last season.
September 30th, 2009 at 9:02 pm
The other two programmers are named Lee and Roy? Ha, very nice nod to gamers.
September 30th, 2009 at 9:31 pm
Loved all the House/Wilson scenes even the one slightly marred by the presence of Cuddy. The animation was fantastic.Andre B.should replace Omar Epps. Don’t recall any of the medicine.
September 30th, 2009 at 10:50 pm
There were a ton of hidden references to gamers and geeks which I appreciated as a programmer/nurse. Joe C. mentioned the Lee and Roy earlier, and they also slipped in one of the programmers referring to his blood effects as “Jenky” (aka Jenkins…look up Leroy Jenkins if you want to understand). The title of “Epic Fail” linked it all together.
Also, Foreman introduced himself as genius “two-point-oh”. There was another possible reference to internet subculture when Cameron mentioned that Chase is gay, a huge gossip-site rumor sparked when the actors broke off their engagement IRL (I’m amazed at their professionalism s/p breakup).
October 1st, 2009 at 12:30 am
@ NurseGracer: Huh??
Where was it mentioned that Jesse Spencer is Gay? Everything on the ‘net is idle speculation and rumor about that..
Chase ain’t gay till he say’s he is….
October 1st, 2009 at 1:31 am
“Epic Fail” is a reference to internet memes, I think, not to any “failing” of anyone in the episode. see: Failblog.com
the animation was far & away from the best graphics ever, but remember, it’s a video game; and those were quite impressive graphics for a video game. the CGI of video games is still several steps away from what they do for films…
October 1st, 2009 at 2:11 am
@Hugh L.
House is living with Wilson at Amber’s old apartment. (Yeah, it’s a little convoluted.) When House got the Vicodin, as Mike Lively mentioned, it was at his old apartment. So if House has access to his old digs, why isn’t he living there? Or why doesn’t Wilson move in there (again)? Why is House keeping his old apartment? I can accept that he’s living with Wilson “to keep (House) from using”… but it still doesn’t why House still has old apartment or who’s paying the rent on it? (If House is living with Wilson, there’s no need to keep the old apartment.)
October 1st, 2009 at 4:15 am
@tro:
Maybe so but don’t you agree that Foreman crashed and burned rather spectacularly during his 1 shot at being a better House then House?
1.) He openly showed greed for House’s job and contempt for House in front of Cuddy before House had even left the Hospital Grounds. Cuddy was also very right to question Foreman’s purported ability to be a better House then House and run the Diagnostics Department.
2.) He let a patient dictate his treatment and never really stood up to him, diminishing his worth both as a leader and a Doctor and showing a fundamental flaw in his character
3.) He let his relationship w/ 13 cloud his judgment as a Doctor
4.) He let one doctor quit without making any effort to try and get him to stay and fired another, putting the jobs of the remaining members of the team in possible jeopardy
5.) By firing 13, he may have tanked his romance with her as well because firing her shows Remy that Foreman doesn’t trust her anymore
How could Foreman have NOT failed epically in all this?
October 1st, 2009 at 6:16 am
Hi,
I agree with Scott the episode was a bit dull. I suppose it was because House himself was not much envolved into investigation the case. I guess, scriptwriters play with the contrast here: House is in – everything is fine, House is out – it all becomes boring. As for me, the only interesting parts were the game and House’s decision to return to diagnostic medicine.
I felt sorry for Foreman as well: he was so much trying to be tough but the department seemed to be falling apart under him anyway. I don’t know: his being ambitious makes him look pathetic sometimes because he can’t be as good as House anyway no matter how hard he tries. Is this the authors’ idea?
October 1st, 2009 at 7:44 am
Of course the chapter’s title is Epic Fail..
The Diagnostic Department without House, didn’t work at all. Even though Foreman had his epiphany, the case was solved by House, and in fact maybe it could have been resolved long time before foreman did.
So, the Diagnostic Department continued, but with Foreman knowing that there’s no way in hell to compare it’s perfomance now with the dept. ran by House.
So, i think that’s the Epic Fail here.
See ya guys next week. Bring it on
Heishiro
October 1st, 2009 at 9:27 am
House may be living with Wilson because Wilson has a good kitchen. Wilson likes to cook and would choose an apt. (with or without April) that has a good stove & work area; he would own plenty of gear. House on the other hand in his usual mode probably does not have a great kitchen or all the pots and pans to obsess with at 3 am.
House’s apartment looked pretty sad. Avoiding it may be part of his attempt to break with the past.
October 1st, 2009 at 3:18 pm
@Hugh L.
Foreman always fails (epically!) without House! I just think the title was an internet meme (granted, with probable double meaning).
October 1st, 2009 at 10:38 pm
@tro:
I agree 100% about Foreman and I agree the episode title probably has many double and triple inside meanings….
Next weeks ep looks like it will ROCK!!
October 2nd, 2009 at 2:51 pm
I want that game so much.
October 3rd, 2009 at 6:10 am
I would miss Taub (if hes really gone) – from the six person working for House he is my favorite character.
That being said, Im not sure if it really goes back to square 1 – Amber got more scrreen time after she was dead ;-) and 13 being Foremans girlfirend (if she till is) would be set to reappear.
In total the axing of Taub and 13 felt so forced as the axing of the prevous team in season 3… So I hope history is not repeating itself.
October 3rd, 2009 at 8:30 am
I just hope the clinic patients come back, they were always the best part of the show!
And yes….Dr. Google has become a huge problem, wonder if there will soon be Internet malpractice insurance.
October 4th, 2009 at 2:18 pm
Hi!
Thanks for your great reviews, I really like them!
I have a question about your links – how do you find them? They are really good, but they come from many different sites, if I’m looking for such a page about a disease what should I google?
October 4th, 2009 at 2:21 pm
House’s moving in with Wilson is explained in the scene in the psychiatrist’s office – when House tells the shrink that he has followed his advice and found a room-mate. There is also a comment later to the effect that being alone is conducive to depression – which is the explanation of the ‘get a room-mate’ advice.
October 5th, 2009 at 7:41 am
The episode was ok for me… A little better than the last one.
Medical diagnosis is what the show is about. Soap opera should be second to that.
My complaint (since the beginning of season one) is that the writers seem to have absolutely no experience of working in a “real” job – I mean one with fixed hours, boss, responsibilities, colleagues, vacations and salary.
In a real life working environment, there would not be so many quittings, unquittings, firings, unfirings, backstabbing, unethical behaviors, bullying of one’s team members, disrespect, bad manners, etc., with NO consequences.
I mean, many of these behaviors DO happen, but not so often and not without ANY consequences (which seems to be the case in the show).
Sometimes they do mention that House is a “lawsuit bait” or something, but it seems that PPTH is House’s playground: he doesn’t need to justify any cost for his department, be it unnecessary exams and/or tests, and damages from lawsuits.
Also, another thing that really , REALLY seems unrealistic is the fact that the team does not seem to have any research/scientific/academic activity. Medicine is one of the most research-related fields of work, but they don’t seem to care about publishing the results for their diagnosis (except for the time Foreman stole Cameron’s idea in season one I guess, but that was only to establish their conflict for drama purposes).
Someone could argue that “it is implicit that they publish, go to congresses etc during the off-screen time, since it is such an ordinary part of their jobs”, but ordinary things do happen during the show (sometimes they eat together, sometimes they mention they go to bathroom, etc.).
What do you medical guys think about that?
October 5th, 2009 at 8:07 pm
A long-time reader spotted a little typo on the review, so I decided to finally comment:
the first priapism is misspelt as priaprism. Just though I’d point out.
Great review, as always :)
October 6th, 2009 at 8:57 am
Great review, as always.
I’m still not happy that House, who is supposed to be the main character, is now taking third billing behind the Foreman/Thirteen show. Although the cooking things were hilarious.
When the PotW was having hallucinations, is it wrong that I thought “Don’t worry about it. In five minutes, everyone but the audience will forget you’re having hallucinations!”? In “Broken,” the hallucinations get a half-hearted mention as House having something more wrong with him than Vicodin addiction. I still want to see those hallucinations addressed, because depression doesn’t cause hallucinations. Remember the narrowing focus last season at the end of that episode about the PotW being locked into his body? One of the first signs that something was very wrong with House. (Although the PotW’s hallucinations were kind of cool.)
I have a medical question, though. House does have chronic pain. Would it be wrong for him to take non-narcotic pain relievers? Something you can’t get addicted to?
Kat
October 6th, 2009 at 9:38 am
Also, I have a nitpick–
Cuddy says that PPTH has the only diagonistic department, because it was started by House. Which is why she was thinking about closing it up (before Foreman asked if he could head it up.) PPTH has the only diagonistic department? When Foreman quit, back in season 3 (or was it 4?), he was going to head a diagonistic department, right? He got fired from it because he went against the rules, but he was head of another hospital’s diagonistic department, right?
Or am I remembering it wrong?
Kat
October 6th, 2009 at 1:29 pm
I have a nit-picky thing related to Fabry disease…
It is an x-linked genetic disease which means this patient’s mother HAD to have the disease. This is the only way he could inherit it unless he has a spontaneous mutation – which is HIGHLY unlikely. Why didn’t we see them talking to the pt about his family members who could also have the disease??
October 6th, 2009 at 9:26 pm
as someone with hypothyroidism, i loved when they suggested it and he had no symptoms.
then it turned into hyperthyroidism – thanks, guys, i wish it worked that way. 6 hours from hypo to hyper! :D
October 10th, 2009 at 11:28 am
Anyway, ‘department of diagnostic medicine’ is indeed not a good idea from the start. It’s just a way of the author to show off House’s cognitive powers.
I’m actually kinda happy if it’s being dismissed from department’s list. So that the real specialists can work in a team based on the case. House is not that genius actually, for one reason he’s not a specialist.
October 11th, 2009 at 2:58 pm
SquishyCat : I’ve long thought that House (the character) was classically ADHD (refusal to do what isn’t fun; never doing paperwork; hyperfocusing; use of drugs (twice as common in untreated ADHD as normal populaton), need for excitement). I’d say Narcissistic Personality Disorder though rather than AntiSocial.
I’ve had been wanting House to do an episode on Fabry’s disease, which is not only much worse than Huntington’s but also more interesting in terms of drama since the gene is on the X chromosome which means men who have not inherited it can have children but their sisters have a very severe moral dilemma. I had thought that Thirteen would be better having Fabry’s than Huntington’s because it would be more interesting dramatically.
Silly me. Once agian, the show has dropped the ball in terms of dramatic potential, proclaiming that Fabry’s is ‘genetic but can be handled medicallyl’, the latter which couldn’t be farther from the truth.
As Jennifer said above, a family history would have given them the answer very quickly.
The handling of Fabry’s disease in this episode = Epic Fail.
In terms of drama, I am so sick of Foreman/Thirteen and House/Cuddy that the best thing the show could do for me would be to send Foreman and Thirteen far away and finally play out House/Cuddy so that it could end. Foreman and Thirteen are both so boring I couldn’t care less about their personal dramas. And as a 40 something professional woman, I find the House/Cuddy interactions both childish and embarassing. Cuddy was much more interesting and believable before they decided to make her the ’ship for House.
October 12th, 2009 at 7:03 am
I was wondering how they would finally get rid of what’s left of the second team (Taub/Thirteen). For at least two seasons now, the opening credits have never had those actors’ names, nor have they shown the characters. I’ve been wondering when they would admit the second team was an epic fail and go back to formula, with Chase, Foreman and (the always irritating) Cameron.
October 15th, 2009 at 2:58 pm
About Foreman firing Thirteen — I wonder if what he meant was that he was firing her from the diagnostic department, with the expectation that she would return to the job she was doing while House was on leave (in the emergency department, I think)? That would put the “firing” closer to garden-variety stupidity rather than breathtakingly idiotic, as firing her from the hospital altogether would be.
I realize this question will probably be answered in the next episode — but I haven’t watched it yet.
October 16th, 2009 at 10:36 pm
The writers of House gave Thirteen Huntington’s because it is much more dramatic than if she had Fabry. Fabry disease can be managed medically (enzyme replacement therapy) and if she had begun treatment early enough – she may never experience any symptoms of her the disease. There is no way around the Huntington’s affecting her. All that can be offered is symptom management. Don’t get me wrong – I would LOVE for Fabry to have a front burner story line like that, as it is a major part of my life but once she begins treatment and her symptoms begin to fade – there is minimal “dramatic” potential. Just my additional “two cents”.
October 18th, 2009 at 1:24 pm
I’m astonished by Foreman’s firing Thirteen. Surely sacking someone who’s doing a fine job professionally in order to smooth over your personal relationship with them is unethical and grounds for a lawsuit? Foreman’s basically saying “I would rather dismiss you for no job-related reason than stop sleeping with you”.
Am I missing something there?
October 19th, 2009 at 10:43 am
Is it just me or has Season 6 of House been, so far a little pathetic? I just cant take to this “New House” He has very few lines, and is no longer sarcastic and witty, and has lost the general nastiness, we all love. I say bring back House, as he was, no more of this new, boring House, as it truely is an “Epic Fail”
November 3rd, 2009 at 9:07 pm
“His mother would have had to have had Fabry’s”
Not necessarily. The gene for Fabry’s is recessive, so his mother could carry it on one X-chromosome but not the other, and thus not develop the disease. However, it is true that a woman with Fabry’s Disease would definitely pass it on to any sons she had, and all her daughters would be carriers, as she would have to have the double-recessive form to develop the disease.
November 14th, 2009 at 8:17 am
As a game designer, I have to say that the trouble they went through to make Vince’s “game” really pissed me off. This has to be the most work someone has put into making a fake game, yet at the end of the day it still looks nothing like a real video game.
November 19th, 2009 at 1:52 pm
I’m glad very little time was spent on the game because the small amount that was annoyed me. It gave me a very tiny taste of what doctors go through watching the show as a rule.
While Lee & Roy may have been a reference to Leeroy Jenkins, the term the developer used was “janky”:
Poorly constructed or of poor quality
http://www.urbandictionary.com/define.php?term=Janky
January 11th, 2010 at 5:04 am
A question for the MDs out there. Patient’s neck swelling is finally explained as a reaction to iodine in the MRI contrast agent. I know that iodine is used as an xray (CT) contrast agent, but is it also used in MRI, which is based on a very different principle?
January 15th, 2010 at 8:24 am
Does anyone have insight on the new filming technique being used? Epic Fail had a totally different look, not only from previous seasons, but from this season’s first double episode.
And would some of those scenes show up in 3-D? They had the look (and, crap, I have glasses!) but I didn’t test it out.
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